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Does Pelvic Rotation Alter Radiologic Measurement of Anterior and Lateral Acetabular Coverage?.

MedStar author(s):

Citation: Arthroscopy. 35(4):1111-1116.e1, 2019 04.PMID: 30857900Department: MedStar Union Memorial HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Acetabulum/dg [Diagnostic Imaging] | *Pelvis | *Rotation | Cadaver | Fluoroscopy | HumansYear: 2019 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:2004 - 2007ISSN:

0749-8063

Name of journal: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy AssociationAbstract: CLINICAL RELEVANCE: This study emphasizes the importance of evaluating pelvic rotation when using the center edge angle to assess femoral head coverage.CONCLUSIONS: Rotation of AP and FP radiographs significantly affects the measured values of the LCEA and ACEA, respectively. The ACEA experiences more dramatic changes with rotation of the FP view compared with the LCEA with the same amount of rotation of an AP view. This study illustrates the importance of verifying the quality of the FP radiograph when using ACEA to guide therapy for hip pathology.Copyright (c) 2019 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.METHODS: Eleven dry cadaveric pelvises from an osteological collection were reconstructed and placed in anatomic position with corresponding bilateral proximal femurs. Conventional anteroposterior (AP) and false-profile (FP) pelvic radiographs were taken at 5degree increments with fluoroscopy from 0degree to 25degree of rotation. LCEA and ACEA were measured for conventional and rotated AP and FP fluoroscopic views, respectively. Statistical analysis was conducted to determine the error in ACEA and LCEA with pelvic rotation.PURPOSE: The purpose of this study was to determine the radiologic tolerance of the lateral center edge angle (LCEA) and anterior center edge angle (ACEA) to pelvic rotation.RESULTS: The mean LCEA was 29.1degree (95% confidence interval [CI], 25.5degree-32.7degree). Mean ACEA was 38.9degree (95% CI, 34.1degree-43.8degree). There was significant change in the LCEA past 10degree of rotation (P = .041). There was significant change in the ACEA with 5<sup>o</sup> or more of rotation (P < .001). The FP view rotated 40degree from an AP view produced 6.8degree (95% CI, 4.7-8.9) of error, whereas one rotated 90degree from an AP view produced 13.2degree (95% CI, 11.2degree-15.3degree) of error in the ACEA. An AP view rotated 25degree toward the x-ray beam produced 2.3degree (95% CI, 1.1degree-3.4degree) error, whereas one rotated 25degree away from the beam produced 2.6degree (95% CI, 1.5degree-3.8degree) of error.All authors: Gould H, Hu E, Li RT, Liu RW, Salata MJ, Valentin NOriginally published: Arthroscopy. 35(4):1111-1116.e1, 2019 Apr.Fiscal year: FY2019Digital Object Identifier:

https://dx.doi.org/10.1016/j.arthro.2018.10.135

Date added to catalog: 2019-05-21

Holdings ( 1 )
Title notes ( 8 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	30857900	Available		30857900

Available online from MWHC library: 1995 - present, Available in print through MWHC library:2004 - 2007

CLINICAL RELEVANCE: This study emphasizes the importance of evaluating pelvic rotation when using the center edge angle to assess femoral head coverage.

CONCLUSIONS: Rotation of AP and FP radiographs significantly affects the measured values of the LCEA and ACEA, respectively. The ACEA experiences more dramatic changes with rotation of the FP view compared with the LCEA with the same amount of rotation of an AP view. This study illustrates the importance of verifying the quality of the FP radiograph when using ACEA to guide therapy for hip pathology.

METHODS: Eleven dry cadaveric pelvises from an osteological collection were reconstructed and placed in anatomic position with corresponding bilateral proximal femurs. Conventional anteroposterior (AP) and false-profile (FP) pelvic radiographs were taken at 5degree increments with fluoroscopy from 0degree to 25degree of rotation. LCEA and ACEA were measured for conventional and rotated AP and FP fluoroscopic views, respectively. Statistical analysis was conducted to determine the error in ACEA and LCEA with pelvic rotation.

PURPOSE: The purpose of this study was to determine the radiologic tolerance of the lateral center edge angle (LCEA) and anterior center edge angle (ACEA) to pelvic rotation.

RESULTS: The mean LCEA was 29.1degree (95% confidence interval [CI], 25.5degree-32.7degree). Mean ACEA was 38.9degree (95% CI, 34.1degree-43.8degree). There was significant change in the LCEA past 10degree of rotation (P = .041). There was significant change in the ACEA with 5<sup>o</sup> or more of rotation (P < .001). The FP view rotated 40degree from an AP view produced 6.8degree (95% CI, 4.7-8.9) of error, whereas one rotated 90degree from an AP view produced 13.2degree (95% CI, 11.2degree-15.3degree) of error in the ACEA. An AP view rotated 25degree toward the x-ray beam produced 2.3degree (95% CI, 1.1degree-3.4degree) error, whereas one rotated 25degree away from the beam produced 2.6degree (95% CI, 1.5degree-3.8degree) of error.

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